HomeMy WebLinkAboutPower Release 06-09-'21 12:14 FROM- 7728787656 T-152 P0009/0009 F-794
Planning &l 061opment Services
Buiidin &Code Riegulajti �n bivision
2300 V'tih jinia Ave
Fort Pierce, FL 34982 .y
772-462-21 y7Z65 Fax / 462-6443
bequest for 30-Day Temporaly POw'r Release -
Date: Permit'Number: /,m�
Project Address.,
THE UNDERSIGNED HERESY REQUEST RELEASE OF ELECTRICAL POWER TO THE ABOVE DESCRIBED
PROPERTY,FOR A PERIOD NOT TO EXCEED THIRTY(30)DAYS, FOR THE PURPOSE OF Ti;STING SYSTEMS
AND EQUIPMENT IN PREPARATION FOR A FINAL INSPKr1ON. IN CONSIDERATION OF APPROVAL OF THE
REQUEST WE HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS,
1. This temporary pour release is requested for the above stated purp6se ontyt and there wM be no
occupancy of any type,other than that permitted by construction during this timer period.
2. As witness by our signatum,we hereby agree to abide by air berms aril conditions of this agreerneM
Including Building Division Policy,which is incorporated herein by reference.
3. All conditions and requirements fisted in the attached document entMed"Requirements for 30 Day
Power for Testingp have been fulfilled and tie premise is ready for compliance inspection.
4. AJI requests for an extension beyond 30 days must be made in writing to the Building Official stating
the reason for the request. Power may be removed.from-the site and/or a Stop Work Order Issued if
the Final Inspection hes not been approved within 30 days. A fee of�100.00 will be required to lift
the Stop Work Order.
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS, Sl: LUCIE COUNTY, AND THEIR EMPLOYEES FROM
ALL LIABILITIES AND CLAIMS OF ANY TYPE OF NATURE WHICH MAY ARI�E NOW OR IN THE FUTURE OUT
OF THIS TRANSACTION.- INCLUDING ANY DAMAGE WHICH i MAY BE INCURRED DUE TO THE
DISCONNECTION OF ELECTRICAL POWER IN THE EVENT OF VIOLATION OF THIS AGREEMENT.
OWNER SIG DATE '
8EN COATr�tAt RE DATE
ELECTRICAL CONTRACTOR SIGNATURE DATE